Purpose To review the sustained effect of COVID-19 on rhegmatogenous retinal detachment (RRD) baseline characteristics and outcomes. Methods This was a retrospective consecutive case series at the Birmingham and Midlands Eye Centre including patients undergoing primary RRD repair between 23 March and 31 December 2017–2019 (Group 1) and 2020 (Group 2). The deciles of indices of multiple deprivation (IMD) were determined by postcode to group patients into least deprived (IMD1-5) and most deprived (IMD6-10). Results In total we reviewed 1310 patients, 1003 in Group 1 and 307 in Group 2. Relative to 2017–2019, during the first lockdown, we observed (a) a reduction in the number of patients with RRD, (b) an increase in macula-off detachments, (c) an increase in RRD primary failure, and (d) that the least deprived had proportionately higher primary failure than the most deprived ( p = 0.049) with a higher detachment rate than the pre-COVID-19 period ( p = 0.010) and increased presentations of macula-off detachment. During the second lockdown, these differences were not observed. Conclusion The previously observed findings of lower presentation rates of RRD during the beginning of the first lockdown and the decreased number of macula-on RRD were not sustained over a longer period of observation or found to recur after a second national lockdown. Patients from areas with the least socioeconomic deprivation seemed to be more negatively affected by the first lockdown, with later presentation and higher rates of re-detachments compared with the most deprived during the first lockdown. Our findings offer reassurance that patient behaviour and health services had adapted to the pandemic by the second national lockdown. Supplementary Information The online version of this article (10.1007/s00717-022-00521-0) contains supplementary material, which is available to authorized users.
PurposeIntermittent exotropia is one of the most common types of strabismus in children especially in Asian and South Asian populations. Prevalence of exotropia in this group is estimated to range from 7–18.5× higher than esotropia. Spontaneous resolution is rare and if neglected may lead to loss of Binocular Single Vision (BSV) and negative psychosocial consequences. We aim to evaluate the outcomes of surgical management for intermittent exotropia at a unit in Birmingham (UK), an area unique for its high non‐White ethnic population (43%), majority of who are Asian/South‐Asian.MethodsRetrospective case notes review of patients diagnosed with intermittent exotropia who underwent strabismus surgery in 2019–2020 by two surgeons using two different surgical approaches with a 3 month follow‐up. Measures included pre‐ and post‐operative visual acuity and stereopsis, surgical indications, near and distance strabismus angle with refractive correction, type of surgery performed and parental satisfaction at follow‐up.ResultsNineteen children underwent surgery during this period with a mean age of 7 range (4–12). Eighteen patients had surgery for functional reasons and one for cosmetic. Two patients recovered BSV where previously Frisby negative, remaining patients maintained BSV. The mean preoperative near and distance exodeviation in prism dioptres (PD) was 30.16 and 34.47, respectively. The mean postoperative near and distance exodeviation was 1.53 PD & 5.16 PD, respectively at 3 months. Two patients developed suture granulomas which resolved with steroid drops post‐operatively. No significant difference between the two surgical techniques was noted. In all cases, parents were satisfied with the results.ConclusionsOutcomes in our multi‐ethnic population have been excellent in terms of improvement in exodeviation and maintenance of BSV. Long‐term follow‐up is required to see how many patients will show evidence of recurrence requiring reoperation and whether ethnicity impacts this.
Background: Giant cell arteritis (GCA) is the most common type of systemic vasculitis affecting the elderly. Ophthalmic presentations of GCA in particular can be difficult to identify prior to permanent visual loss occurring. Methods: Here, we present 3 challenging cases as a retrospective series to highlight the variable presentations of GCA with ophthalmic involvement, but GCA was not suspected due to atypical presentation. Results: Unfortunately, all 3 cases went on to develop visual loss in the affected eye due to a delay in diagnosis or treatment. The authors wish to highlight the challenges posed to the referring clinicians, when patients had systemic/ocular co-morbidities, which delayed the suspicion of GCA Conclusion with a Practical Point: Our cases highlight the variable presentations of this condition as well as the devastating ophthalmic implications that GCA can have. A high index of suspicion must be maintained; particularly in elderly patients with atypical presentations.
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